Research

Our Foundation

Zephyr is committed to the clinical validation of our products and technologies ensuring their safety, comfort, quality.

MATRx plus (Feedback Controlled Mandibular Positioner)

A feedback-controlled mandibular positioner identifies individuals with sleep apnea who will respond to oral appliance therapy.

Remmers JE, Topor Z, Grosse J, Vranjes N, Mosca EV, Brant R, Bruehlmann S, Charkhandeh S, Jahromi SA. J Clin Sleep Med 2017; 13(7): 871–880.
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A mandibular positioning home sleep test prospectively predicts outcome of oral appliance therapy for OSA using retrospectively derived decision criteria.

Remmers, J.E., Zareian A., Topor Z., Grosse J., Vranjes N., Charkhandeh S. In Proceedings at the 25th Annual Meeting of the AADSM (Poster Board #015). Denver, CO. June 9-11, 2016.
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Prediction of outcome with oral appliance therapy for obstructive sleep apnea using in-home mandibular titration.

Remmers, J.E., Zareian A., Topor Z., Grosse J., Vranjes N., Charkhandeh S. In Proceedings at ATS 2016 International Conference (Poster details: A7467; Poster Board P1089). San Francisco, CA. May 13-18, 2016.
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An auto-titrating mandibular positioner: accuracy in predicting oral appliance therapy and efficacious mandibular protrusion.

Charkhandeh S., Topor Z., Grosse J., Vranjes N., Zareian S.A., D’Andrea J., Bruehlmann S., Remmers J.E. In Proceedings at the 24th Annual Meeting of the AADSM and SLEEP 2015 (Abstract ID#17: AADSM Poster Board #017; APSS Poster Board #363). Seattle, WA. June 4-10, 2015.
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Predicting oral appliance therapy outcome using an auto-adjusting mandibular positioner in the home.

Topor Z., Grosse J., Zareian Jahromi S.A., D’Andrea J., Bruehlmann S., Charkhandeh S., Remmers J.E. In Proceedings at the 2015 ATS Conference (Abstract ID #62764). Denver, CO. May 15-20, 2015.
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MATRx (Remote Controlled Mandibular Positioner)

Performance of remotely controlled mandibular protrusion sleep studies for prediction of oral appliance treatment response.

Sutherland K, Ngiam J, Cistulli PA. J Clin Sleep Med 2016 (in press).
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The use of remotely controlled mandibular positioner as a predictive screening tool for mandibular advancement device therapy in patients with obstructive sleep apnea through single-night progressive titration of the mandible: A systemic review.

Kastoer C, Dieltjens M, Oorts E, Hamans E, Braem MJ, Van de Heyning PH, Vanderveken OM. J Clin Sleep Med 2016; 12(10): 1411-1421.
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Mandibular advancement device titration using a remote controlled mandibular positioner.

Omar E. Burschtin MD, David S. Binder DDS, Jason Lim BA, Samantha Marsiliani RDH, Indu Ayappa PhD, David M. Rapoport MD. In Proceedings at the 2014 SLEEP (Poster Presentation, Poster Board #252; Publication Page 168, #0426). Minnesota, Minneapolis, June 1-4, 2014.
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Remotely controlled mandibular protrusion during sleep predicts therapeutic success with oral appliances in patients with obstructive sleep apnea.

Remmers J, Charkhandeh S, Grosse J, Topor Z, Brant R, Santosham P, Bruehlmann S. SLEEP 2013; 36(10): 1517-1525.
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Selecting OSA patients for oral appliance therapy by mandibular protrusive titration: effect of hypopnea scoring criteria on predictive accuracy.

Remmers J, Charkhandeh S, Topor Z, Grosse J, Santosham P, Bruehlmann S. In Proceedings at the 2012 SLEEP Conference (Poster Presentation, Poster Board #193; Publication Page A195, #0576). Boston, Massachusetts, June 9-13, 2012.
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Target protrusive position from mandibular protrusion titration: is it a good estimate of adequate protrusion? Does it Correlate with RDI or BMI?

Charkhandeh S, Topor ZL, Grosse JC, Santosham P, Bruehlmann S and Remmers JE. In Proceedings at the 21st Annual Meeting of the AADSM at the SLEEP 2012 Conference (Poster Presentation & Podium, Poster Board #001; Publication Page 29). Boston, Massachusetts, June 7-9, 2012.
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Mandibular protrusion during sleep predicts outcome with oral appliance therapy of sleep apnea.

Remmers J, Charkhandeh S, Topor Z, Grosse J, Bruehlmann S. In Proceedings at the ATS 2012 International Conference (Poster Presentation, Poster Board #616; Publication Page A3855). San Francisco, California, May 18-23, 2012.
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Selection of obstructive sleep apnea patients for oral appliance therapy.

Remmers J. In Proceedings of the World Sleep 2011 Conference (Invited Lecturer). Kyoto, Japan, October 16-20, 2011.

Selection of patients for oral appliance therapy using mandibular protrusion during sleep.

Charkhandeh S, Topor Z, Grosse J, Turner M, Remmers J. In Proceedings at the 2011 SLEEP Conference (Publication Page A117, #0331). Minneapolis, Minnesota, June 12-15, 2011.
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Mandibular advancement and obstructive sleep apnea: a method for determining effective mandibular protrusion.

Dort LC, Hadjuk E, Remmers JE. Eur Respir J 2006; 27(5):1003-9.
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Remotely controlled mandibular positioner predicts efficacy of oral appliances in sleep apnea.

Tsai WH, Vazquez J, Oshima T, Dort LC, Roycroft B, Lowe A, Hadjuk E, Remmers JE, Am J Respir Crit Care Med 2004; 170(4): 366-70.
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Oral Appliance Therapy: Clinical Evidence

Clinical practice guideline for the treatment of obstructive sleep apnea and snoring with oral appliance therapy: An update for 2015.

Ramar K, Dort LC, Katz SG, Lettieri CJ, Harrod CG, Thomas SM, Chervin RD. J Clin Sleep Med 2015; 11(7): 773–827.
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Oral Appliance Treatment for Obstructive Sleep Apnea: An Update.

Sutherland K, Vanderveken O, Tsuda H, Marklund M, Gagnadoux F, Kushida C, Cistulli P, Source, Journal of Clinical Sleep Medicine, Vol 10 No 2, 2014.
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Oral Appliance Therapy: Clinical Efficacy/Preference

A fully digital workflow and device manufacturing for mandibular repositioning devices for the treatment of obstructive sleep apnea: A feasibility study.

Charkhandeh S, Kuhns D, Kim S. Journal of Dental Sleep Medicine. 2017; 4(4): 97–102.
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CPAP vs. mandibular advancement devices and blood pressure in patients with obstructive sleep apnea: A systematic review and meta-analysis.

Bratton DJ, Gaisl T, Wons A, Kohler M, JAMA. 2015 Dec 1; 314(21): 2280-93.
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Meta-analysis of randomised controlled trials of oral mandibular advancement devices and continuous positive airway pressure for obstructive sleep apnoea-hypopnoea.

Linda Sharples, Abigail Clutterbuck-James, Matthew Glover, Maxine Bennett, Rebecca Chadwick, Marcus Pittman, Timothy Quinnell. Sleep Med Review 2015 May 30.
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Effects of treatment with oral appliance on 24-h blood pressure in patients with obstructive sleep apnea and hypertension: a randomized clinical trial.

Andrén A1, Hedberg P, Walker-Engström ML, Wahlén P, Tegelberg A. Sleep Breath. 2013 May; 17(2): 705-12.
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Patient preferences and experiences of CPAP and oral appliances for the treatment of obstructive sleep apnea: a qualitative analysis.

Almeida FR1, Henrich N, Marra C, Lynd LD, Lowe AA, Tsuda H, Fleetham JA, Pliska B, Ayas N. Sleep Breath. 2013 May; 17(2):659-66.
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Mandibular advancement splint as short-term alternative treatment in patients with obstructive sleep apnea already effectively treated with continuous positive airway pressure.

Almeida FR1, Mulgrew A, Ayas N, Tsuda H, Lowe AA, Fox N, Harrison S, Fleetham JA. J Clin Sleep Med. 2013 Apr 15; 9(4):319-24.
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Mandibular advancement appliances remain effective in lowering respiratory disturbance index for 2.5-4.5 years.

Gauthier L1, Laberge L, Beaudry M, Laforte M, Rompré PH, Lavigne GJ., Sleep Med. 2011 Oct;12(9): 844-9. doi: 10.1016/j.sleep.2011.05.004. Epub 2011 Sep 16.
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Dental appliance treatment for obstructive sleep apnea.

Chan AS, Lee RW, Cistulli PA. Centre for Sleep Health and Research, Royal North Shore Hospital, St Leonards NSW 2065, Australia.CHEST. 2007 Aug; 132(2): 693-9.
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Long-term compliance and side effects of oral appliances used for the treatment of snoring and obstructive sleep apnea syndrome.

Almeida FR1, Lowe AA, Tsuiki S, Otsuka R, Wong M, Fastlicht S, Ryan F. J Clin Sleep Med. 2005 Apr 15;1(2):143-52.
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Treatment of snoring and obstructive sleep apnea with mandibular repositioning appliances.

Peter A. Cistulli, Helen Gotsopoulos, Marie Marklund and Alan A. Lowe. Sleep Med Reviews, Vol 8 Iss 6 pp 427-499 (2004) Copyright © 2005 Elsevier Ltd. All rights reserved.
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Oral Appliance Therapy: Evidence for Improved Outcomes

Alternatives to continuous positive airway pressure 2: mandibular advancement devices compared.

Quinnell TG1, Clutterbuck-James AL. Curr Opin Pulm Med. 2014 Nov; 20(6):595-600.
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Modulation of Inflammatory and Hemostatic Markers in Obstructive Sleep Apnea Patients Treated with Mandibular Advancement Splints: A Parallel, Controlled Trial.

Nizankowska-Jedrzejczyk A1, Almeida FR2, Lowe AA2, Kania A3, Nastałek P3, Mejza F3, Foley JH4, Nizankowska-Mogilnicka E3, Undas A5. J Clin Sleep Med. 2014 Mar 15; 10(3): 255-62.
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Mandibular Advancement device and CPAP upon cardiovascular parameters in OSA.

Cibele Dal-Fabbro, Silvério Garbuio, Vânia D’Almeida, Fátima D. Cintra, Sergio Tu_k, Lia Bittencourt. Sleep. 2014 January 26.
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Cardiovascular mortality in obstructive sleep apnea treated with continuous positive airway pressure or oral appliance: An observational study.

Anandam A, Patil M, Akinnusi M, Jaoude P, El-Solh AA. Respirology. 2013 Nov; 18(8): 1184-90.
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Health outcomes of continuous positive airway pressure versus oral appliance treatment for obstructive sleep apnea: A randomized controlled trial.

Phillips CL, Grunstein RR, Darendeliler MA, Mihailidou AS, Srinivasan VK, Yee BJ, Marks GB, Cistulli PA. Am J Respir Crit Care Med 2013; 187(8): 879-887.
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Continuous positive airway pressure versus the mandibular advancing splint: Are they equally effective in obstructive sleep apnea management?

White DP. Am J Respir Crit Care Med 2013 Editorial; 187:795-797.
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Effect of oral appliances on blood pressure in obstructive sleep apnea: a systematic review and meta-analysis.

Iftikhar IH1, Hays ER, Iverson MA, Magalang UJ, Maas AK. J Clin Sleep Med. 2013 Feb 1; 9(2):165-74.
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Effect of oral appliance therapy on neurobehavioral functioning in obstructive sleep apnea: a randomized controlled trial.

Naismith SL1, Winter VR, Hickie IB, Cistulli PA. J Clin Sleep Med. 2005 Oct 15; 1(4): 374-80.
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Oral appliance therapy reduces blood pressure in obstructive sleep apnea: a randomized, controlled trial.

Gotsopoulos H, Kelly JJ, Cistulli PA. Department of Respiratory & Sleep Medicine, St George Hospital, The University of New South Wales, Sydney Australia Sleep. 2004 Aug 1; 27(5):934-41.
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New Technology: Clinical Evidence

Non-invasive identification of inspiratory flow limitation in patients sleeping with an oral appliance in place.

S.A. Zareian Jahromi, PhD, J. Grosse, MMath, Z.L. Topor, PhD, J. Sun, PhD, Q. Sun PhD, J.E. Remmers, PhD. In Proceedings at ATS 2014 (Poster Presentation, Poster Board #H70; Publication Number: A3599). San Diego, California, May 16-21, 2014.
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Objectively measured vs self-reported compliance during oral appliance therapy for sleep-disordered breathing.

Dieltjens M, Braem MJ, Vroegop AV, Wouters K, Verbraecken JA, De Backer WA, Van de Heyning PH, Vanderveken OM. Chest. 2013 Nov; 144(5): 1495-502.
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Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing.

Vanderveken OM, Dieltjens M, Wouters K, De Backer WA, Van de Heyning PH, Braem MJ et al. Thorax 2013; 68:91-96.
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Drug-induced sleep endoscopy completed with a simulation bit approach for the prediction of the outcome of treatment of obstructive sleep apnea with mandibular repositioning appliances.

Vanderveken OM, Vroegop AV, MD, Van de Heyning PH, Braem MJ. Operative Techniques in Otolaryngology 2011; 22(2): 175-182.
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